An exploratory study into whether self-monitoring improves adherence to daily flossing among dental patients

Objectives: This exploratory study evaluated the effectiveness of an action-control behavioral intervention on adherence to dental flossing in patients with periodontal disease. Action control, that is, monitoring one's behavior and evaluating it against a self-set standard, has been suggested as a self-regulatory strategy that can assist people who intend to engage in behavioral change. Methods: In a single-center, single-blind prospective trial, 73 dental patients received a behavioral intervention, which was either matched or mismatched to their stage of behavioral change. Through responses to a standardized self-report measure, participants were classified either as motivational (i.e., not ready to change) or volitional (i.e., contemplating change) with regard to dental flossing. The intervention consisted of a simple self-monitoring tool for dental flossing in the form of a diary. Flossing frequency, dental plaque, and bleeding scores were measured before and at 4 weeks postintervention. Results: Flossing frequency, dental plaque, and bleeding scores improved (P < 0.001) in both stage-matched and stage-mismatched patients. Conclusions: A brief behavioral intervention enhances adherence to dental flossing, regardless of participants' stage of change. Keeping a flossing diary can increase dental flossing and reduce plaque and bleeding scores in patients with periodontal disease, in the short term.